Enteral supplementation with glycyl-glutamine improves intestinal barrier function after liver transplantation in rats

摘要

BACKGROUND: Most  patients  after  liver  transplantation  (LT) suffer  from  intestinal  barrier  dysfunction.  Glycyl-glutamine (Gly-Gln)  by  parenteral  supplementation  is  hydrolyzed  to release glutamine, which improves intestinal barrier function in intestinal injury. This study aimed to investigate the effect of Gly-Gln by enteral supplementation on intestinal barrier function in rats after allogenetic LT under immunosuppressive therapy. METHODS:  Twelve inbred Lewis rats were selected randomly as donors, and 24 inbred Brown Norway (BN) rats as recipients of  allogenetic  LT.  The  recipients  were  divided  into  a  control group (Ala, n=12) and an experimental group (Gly-Gln, n=12). In  each  group,  6  normal  BN  rats  were  sampled  for  normal parameters  on  preoperative  day  3.  The  6  recipients  in  the control group received alanine (Ala) daily by gastric perfusion for  3  preoperative  days  and  7  postoperative  days,  and  the  6 recipients  in  the  experimental  group  were  given  Gly-Gln  in the same manner. The 12 BN recipients underwent orthotopic LT under sterile conditions after a 3-day fast and were given immunosuppressive therapy for 7 days. They were harvested for sampling on postoperative day 8. The following parameters were  assessed:  intestinal  mucosal  protein  content,  mucosal ultrastructure, ileocecal sIgA content, portal plasma levels of endotoxin and TNF-α, and bacterial translocation. RESULTS: All recipients were alive after LT. On preoperative day  3,  all  parameters  were  similar  in  the  two  groups.  On postoperative  day  8,  all  parameters  in  the  two  groups  were remarkably  changed  from  those  on  preoperative  day  3. However,  compared  to  the  Ala  group,  supplementation  with Gly-Gln increased the levels of intestinal mucosal protein and ileocecal  sIgA,  improved  mucosal  microvilli,  and  decreased portal  plasma  levels  of  endotoxin  and  TNF-α  as  well  as bacterial translocation. CONCLUSION: Enteral supplementation with Gly-Gln improved intestinal barrier function after allogenetic LT in rats.